In the Garden of Eden, during the fall of man, God asked Adam: "Have you eaten of the tree of which I commanded you not to eat?" Adam answered by blaming his wife, Eve. And when God asked the woman: "What is this that you have done?" Eve responded by blaming the serpent. Man's inability to take responsibility for his wrongs, it seems, was embedded in his genetic makeup from the beginning of time.

In my twenty-five years in private practice, there has been plenty of serpents to blame for my personal and business woes. I was never short of excuses for my failures, shielding myself in the process from my inadequacies. I had also witnessed dozens of colleagues abandoning the medical profession, driven to other fields, and hiding behind similar excuses to mine for their failure.

Some had gone on to thrive in their newly found occupations, but for others, disappointment stalked the rest of their professional lives. For the latter, I am certain no other question tormented them more than: What does it take to win? What does it take to get things right in their floundering medical practises?

Winning in business is a seminal objective since success extends beyond the individual. Not only do our health practises prosper but also our families, children and marriages win. Winning at work can lead to being a champion at home. If for anything else then, that is why the message contained in Dr. Makuluma's compelling and riveting book is vital. Inspired by his own experience, and profoundly stirred by the doom he witnessed in private practice, the author's sublime 'project' reminds us that success, and indeed failure in health care practice, is often not by accident.

Success, he tells us, is a choice. When we run a race, we should do so with the mind of a champion: and that is do so with a plan to win and not surrender to the myriad business setbacks endemic in the medical profession.

In "The Business of Health Care" Dr. Makuluma gives us his blueprint-a strategy which when properly executed would eliminate flaws in private health practice, unravel the mystery behind success, and lead to victory. The genius of his plan is the sheer simplicity of its precepts. The author readily confronts the complexities of running a medical practice with carefully thought out principles, and with also simple but deliberate language.

From the outset, he jolts the reader with invaluable advice: The key to successfully operate a health practice is to be financially literate. This is the "basic formula", he writes, for operating any business. On the surface this observation is obvious, and yet it remains the cardinal reason for the failure of many health practises.

It has also been stated repeatedly in several different ways throughout the ages. "A fool and his money are soon parted": goes the old adage. "The men who can manage men manage the men who can manage things, and the men who can manage money, manage all." _Will And Ariel Durant, The Lesson of History.

In my practice, I never saw my role extending beyond my skills as a surgeon. My energies were continually sapped by improving my surgical skills. My relationship with my practice as a business, was at best lukewarm. I had, more than most, put in the long hours at work, but I had failed to grasp the very simple notion that I was a 'health practitioner running a business,' as the author so aptly and eloquently puts it.

As with the unprofitable servant in the biblical parable of talents, my thoughts on money were restricted to the fear of losing it, than in making it. When it came to wealth, and its creation, my mind mostly saw limitations rather than possibilities. Hardship was consequently the fingerprint of my practice, and financial ignorance was engraved in its soul. My professional life was a narrative of unfulfilled dreams.

The Business of Health Care is the strategic omnibus that will undoubtedly carry the modern medical practitioners into the future. It is a well-written and well-researched book, and is destined to be the bible for all doctors going into private practice. In it, Dr. Makuluma, takes us by the hand and offers the treasures and tools of running a successful practise in the twenty-first century.

The author's 'project' is a priceless gift to health practitioners. It is an august framework for success, underpinned by the supremacy of design. Dr. Makuluma provides the implements not just to manage a business, but also to manage life.

After reading the book, it is as if one has suddenly woken up from a nightmare. It is difficult to suppress the indignation at the harm which ignorance has wrought upon our venerable profession. But, now doubt has been supplanted with optimism. One now approaches every day at work, and every challenge, with renewed hopes and sense of purpose.